PT - JOURNAL ARTICLE AU - Cross-Sudworth, F AU - Williams, M AU - Bird, I AU - Gardosi, J TI - Community midwife care pathways and confidence levels in providing maternity care in areas of high deprivation AID - 10.1136/adc.2010.189761.30 DP - 2010 Jun 01 TA - Archives of Disease in Childhood - Fetal and Neonatal Edition PG - Fa98--Fa98 VI - 95 IP - Suppl 1 4099 - http://fn.bmj.com/content/95/Suppl_1/Fa98.2.short 4100 - http://fn.bmj.com/content/95/Suppl_1/Fa98.2.full SO - Arch Dis Child Fetal Neonatal Ed2010 Jun 01; 95 AB - Background Good community based maternity care requires clear care pathways and confidence in their application. The authors wanted to investigate how well community midwives (CMWs) considered themselves able to deal with a set of problems. Method Survey of 278 CMWs serving six large maternity units with above average levels of deprivation. Anonymised semistructured questionnaire included questions about 12 areas of care. Results were expressed as the proportion of CMWs who reported that they were unaware or unsure of a care pathway, and those who were not confident or unsure about that particular area of care. Results 213 questionnaires were returned (response rate 77%). There was wide variation in presence of care pathways and confidence levels for different tasks, with better results for smoking, drugs & alcohol and mental health issues, and poor rates for issues such as poverty, housing, migrants & asylum seekers and women with physical and learning difficulties (table). Unaware or unsure of a care pathway (%)Not confident or unsure in providing care (%)Smoking cessation22.83.4Drug/alcohol misuse17.527.8Obesity46.550.0Poverty89.057.0Inadequate housing90.867.1Non-English speaking migrants68.528.3Asylum seekers84.974.0Mental health problems12.718.0Teenagers25.911.1Child protection issues5.313.0Domestic abuse23.233.1Physical or learning difficulties77.276. Conclusion There is an urgent need for standardised care pathways and better training to cover all areas of need, including those characteristic of deprived areas, to allow CMWs to deliver an equitable maternity service.